MANITOBA PSYCHOLOGIST
Vol. 21, #3, 4
Summer/Fall, 2002
THE PSYCHOLOGICAL ASSOCIATION OF MANITOBA
L’ASSOCIATION DES PSYCHOLOGUES DU MANITOBA
162-2025 Corydon Avenue, #253, Winnipeg, MB R3P 0N5 204-487-0784
E-Mail: PAM@mb.sympatico.ca
PAM is legally constituted by the Psychologists Registration Act (R.S.M. 1987) as the regulatory body for the practice of all branches
of Psychology in Manitoba
PSYCHOLOGISTS REGISTRATION ACT
As noted previously in the Manitoba
Psychologist, an amended Psychologists
Registration Act was passed on July 6th, 2001 to
bring our act into compliance with the
Agreement on Internal Trade and to increase
consistency in the regulation of health service
providers. PAM Council, in collaboration with
the Legislative Review Committee and our legal
counsel, continues its work on the development
of the necessary by-laws and regulations
associated with the amended Act.
At present, the provincial government is
continuing its work on a new version of the
Psychologists Act, examining how its various
branches will be affected by different aspects of
the Act.
35th ANNIVERSARY OF PSYCHOLOGY
BECOMING A REGULATED
PROFESSION IN MANITOBA submitted by
Dr. Kenneth Enns, C.Psych., Member at
Large, PAM Council
This year marks the 35th anniversary of
Psychology becoming a regulated profession in
Manitoba. The Psychologists Registration Act,
the original Psychology regulatory act, was
prepared by an unincorporated Psychology
fraternal association, the Manitoba Psychological
Association, and passed by the Manitoba
Legislature, in 1966. The Act came into force in
1967, with the first “registered psychologists”
certified in that year.
The original Manitoba Psychological
Association was dissolved, and replaced by two
organizations, in 1967. The Psychological
Association of Manitoba was formed as the
provincial Psychology regulatory organization,
and the Manitoba Psychological Society was
formed as the provincial fraternal organization
for registered and non-registered psychologists.
MPS was constituted to advance Psychology as a
science, profession, and benefit to human beings.
In this capacity, MPS acts as the lobbying
association for the professional interests of
psychologists, and also provides continuing
education programs to psychologists.
The Psychological Association of Manitoba was
given its particular name, in part, to distinguish
itself from the earlier Manitoba Psychological
Association and to give it different initial letters
from the Manitoba Psychiatric Association. At
the time, the Manitoba government did not give
the Psychology regulatory body the name of
‘Manitoba College of Psychologists,’ although
its mandate was to operate as such a regulatory
college. PAM has proposed that its name be
changed to the Manitoba College of
Psychologists in its proposed new Psychology
regulatory Act, to better reflect both its legislated
function and the current practice for Psychology
in many other Canadian provinces.
Published quarterly by the Psychological Association of Manitoba. ISSN0711-1533
This is the official publication of the Psychological Association of Manitoba. Its primary purpose is to assist PAM to fulfill its legal
responsibilities concerning the protection of the public and regulation of psychology in Manitoba. It also seeks to foster
communication within the psychological community and between psychologists and the larger community.
Editor: Dr. Donald Stewart, c/o 474 University Centre, University of Manitoba, Winnipeg, MB R3T 2N2
BRIEF OVERVIEW OF SOME OF THE
CHILD PROTECTION
RESPONSIBILITIES OF REGISTERED
PSYCHOLOGISTS submitted by Dr.
Leonard Greenwood, C.Psych., Child
Protection Centre
I have been asked to provide an overview of
the responsibilities of Psychologists in
matters where the abuse of a child is being
investigated. I am happy to do so.
Revisions to the Act regarding such matters
and more recent guidelines to that Act
warrant our attention. Areas I will note
include the fact that reporting of child abuse
is required regardless of when it occurred,
that investigators have unrestricted access to
all relevant records, and that if you report
concerns you are now entitled to know the
outcome of the investigation.
In Manitoba, the laws defining child abuse
and the requirements for professionals to
respond to such situations suggestive of past
or present child abuse are contained within
The Child and Family Services Act of
Manitoba, hereafter referred to as ‘the Act’,
proclaimed 15 March 1999. There has also
been published a set of guidelines to assist
us in responding in a manner consistent with
the Act: The Revised Manitoba Guidelines
on Identifying and Reporting a Child in
Need of Protection (Including Child Abuse),
August 2001 (Guidelines). These, plus our
own CPA Code of Ethics (COE) and
companion documents, especially Practice
Guidelines for Providers of Psychological
Services (GPPS), are the basic reference
library for professional conduct in matters
regarding child protection.
Defining Child Protection Issues
Perhaps the first place to begin is by noting
that according to the Act, a child is in need
of protection “where the life, health or
emotional well being of the child is
endangered by the act or omission of a
person’’ (part of subsection 17(1) of the
Act). Therefore, how you manage your
obtained information, records, observations
and professional opinion are relevant for
consideration under the Act. The Act and
Guidelines define our legislated
responsibilities when we encounter
information suggesting that a child is in
need of protection.
Requirement to report. The first decision
we often face is that of when and if to report
protection concerns. According to the Act,
if you as a professional (or private citizen)
are led “to reasonably believe that a child is
or might be in need of protection…[you]
shall forthwith report the information to an
[mandated] agency or to a parent or
guardian of the child” (part of subsection
18(1)). There is no professional privilege in
this matter. According to the Guidelines,
“the duty to report applies even where the
person has acquired the information through
the discharge of professional duties or
within a confidential relationship such as a
doctor-patient relationship” (Part (1) 4).
The consequences for not doing so can be
significant. The Director of Child and
Family Services can make a complaint to the
Psychological Association of Manitoba
(PAM). Conversely, if you do report in
good faith, no action can be brought against
you.
The COE is consistent with this
requirement. The COE requires that we
undertake to reasonably offset threats of
serious harm by reporting to those
authorities who can intervene (COE II. 39),
to be cognizant of the possible tension
between legal requirements and the COE
(COE Responsibility to Society IV.17), and
to consult with colleagues when legal
requirements are potentially in conflict with
ethical principles (COE IV.18). We as
psychologists are not mandated to conclude
that a child is in need of protection, but must
forward any information that would allow
others to make the necessary conclusions.
Reporting that a Child may be in Need of
Protection
Having information deemed reportable, the
next question becomes: To whom does one
report? At first glance, there appears to be
considerable discretion. The Act suggests
the professional might report to the
mandated agency or to a parent or guardian.
However, the Guidelines indicate that there
are conditions under which reporting to a
parent or guardian is not correct. The report
should proceed to the agency when the
parent is the cause of the problem, or the
parent is unable or unwilling to protect the
child. Interestingly, the parent should also
not receive the report if the information
leads you to believe the child might be at
risk for abuse or is the target of abuse by a
parent, or person in charge of the child.
This clearly targets instances of intrafamilial allegations, be it in a nuclear family
or stepfamily setting. Further, if you do
report protection concerns to a parent, you
have not completed your obligations.
According to the Guidelines, if you do
report the abuse to a parent and they
thereafter give you reason to doubt they can
or will move to protect the child, you have a
continuing responsibility to report to a
mandated agency.
Given these caveats and conditions, I
recommend that you involve a mandated
agency on almost all occasions. There may
be instances where you are strongly
convinced that reporting your concern to a
parent is a sufficient response to the Act,
and is clinically the best course for your
client. Even in such a case, I recommend
that you review the case, in anonymous
fashion, with a CFS protection worker to
determine that no report to an agency is
required, and then document that you have
done so.
Maintaining a working relationship with
your client. Our sense of responsibility to
our client and our ethical code (COE II
Minimize Harm, III Integrity of
Relationships) compels us to transform such
arbitrary acts as reporting protection
concerns into a collaborative activity that
involves the parents of a client. However,
consult with a protection worker first. If
you gain an opinion from CFS that an
investigation is warranted, you may also be
advised not to inform the parent of your
concerns.
Issues relating to how to report are best
discussed within two contexts -- the need to
protect a child from recent or ongoing abuse,
and the need to respond to failures to protect
a child from past abuse.
Disclosing current protection concerns.
Where the information suggests there is
recent or current abuse of a child, a report
must be made. The Guidelines indicate we
cannot inform a non-offending parent about
the allegation and our reporting. In fact
once the report is made we lose the power of
choice regarding informing collaterals of the
allegation. According to the Guidelines,
“Once a report has been made, the agency
assumes responsibility for informing the
parent or guardian” (Part (2) 4). Ethically
this is not a healthy process and it isolates us
from empowering both our client and the
investigative process.
There exists a role for us in discussing with
the client or the client’s parent how (not if)
the report might be made to CFS. Before
you do this, however, discuss your ideas on
this matter in anonymous fashion with the
CFS. Protection workers are very aware that
allegations are often made impulsively or
unintentionally, with ambivalence and with
fear of reprisal. You may find the worker
agreeable to you processing the act of
reporting in a collaborative manner with
your client. In practice, any groundwork
that enhances the safety of the source of
allegations facilitates the efforts to protect
the child. In some cases, your consultation
with CFS may alert you to the fact that this
allegation falls in a context of chronic issues
or additional protection concerns. In such
cases, collaboration may be a lesser issue.
In all cases where you do act in
collaboration regarding reporting, do not
conduct an investigative interview. Such
interviews are mandated to others. Your
investigative behavior may compromise
their work and the protection of a child.
Some of the angst and concern regarding the
impact that our reporting of these allegations
might have on our client can be prevented.
When beginning any work with a client,
advise the client regarding the limits of
confidentiality (GPPS III.1, V.2, & V.3). In
some cases, especially where disclosures can
be anticipated, consider undertaking a
detailed discussion of how you and the
client (if an adult) might fulfill your shared
responsibilities in this regard.
Disclosing historical abuse. I wish to
anchor this discussion by making a point of
distinction: The perspective on past
allegations considered here is not that of
calling a perpetrator to account for harm
done, nor assisting a survivor adjust to past
maltreatment. Descriptions of criminal acts
are a police matter. The focus here is only
on the question, Does information provided
indicate a child is or is likely to be harmed?
When the information we obtain points to
past abuse rather than the present need for
protection of a child, we may anticipate
some room for judgment regarding reporting
(e.g., if COE II.39 ‘duty to protect’ is not
applicable). However, the Guidelines are
clear. Situations where past abuse is
reported are to be handled in the same way
as those alleging current abuse (Guidelines
Part (2) 6). There is no stated statute of
limitations on our onus to report in this
regard. In talking to authors of the
Guidelines, they point to concerns that
alleged perpetrators of historical abuse may
still be harming other children. They urge
that the psychologist consult with a
mandated agency regarding whether
material is reportable.
As clinicians, current practice might lead us
to leave the decision regarding reporting to
our client. For example, an adult client may
recall abuse but not feel able or yet ready to
make public the facts of their victimization.
Such a practice does not conform to the
Guidelines and perhaps our profession might
advocate for clarification on this point. The
Guidelines do not stand alone in opposition
to this practice. The COE notes that the
consideration of consequences to others
requires we disallow certain client rights.
The law has given the opinion that
allegations, once made, have consequences
for others that take priority, and we are not
the ones charged with determining the
seriousness of those consequences.
It would seem prudent where past abuse is
alleged for clinicians to take the following
steps:
1. They record in detail the
allegation, including the identity
and present location of the
offending person. If possible, gain
some idea whether the offending
person continues to be in a position
where they can abuse children.
2. Discuss with your client whether
they have previously reported the
abuse and their concerns about
doing so now. Explore any fears
they have that reporting the abuse
will result in harm to themselves or
others.
3. Consult anonymously with CFS
and a colleague regarding the
significance of the report and the
potential need to protect.
Document that you have done so.
4. Unless explicitly directed
otherwise by CFS, inform the
client of your ethical opinion and
make an effort to address the
reporting issue collaboratively.
These decisions require a careful and
documented evaluation on a case-by-case
basis. Arbitrary decisions may
compromise your client, your relationship
with your client, or fail to protect others
from present or future harm. In this case
both responsibilities to the client and to
society need to be measured.
Confidentiality and Clinical Documents
There are specific rules regarding
confidentiality when there is a question of a
child in need of protection. In the context of
a child protection investigation, the CFS
agency, the police, and medical personnel
have mandated responsibilities that require
exchange of information without a client’s
consent: “[T]here shall be mutual sharing of
all relevant information by the agencies and
professionals involved” (Guidelines Part(3)).
The Child and Family Services Agency is
required to arrange for medical and police
involvement and “to share all relevant
information of a confidential nature”
(Guidelines Part (3) 1).
There are no exceptions with regard to the
requirement to provide information. The
Act supersedes all other provincial
legislation. For example, the Personal
Health Information Act (PHIA) subsection
22(2) allows for disclosure of information
without consent if required by the Act. Our
own COE requires you share confidential
information when required by law (COE
Responsible Caring I. 45).
Those mandated can request your
documents where relevant. It is therefore
recommended that you obtain in writing
their request for information, but you cannot
stall, edit, or limit their access to your
records. I recommend that you maintain
your standard of recording such that no
question can be raised about uneven
documentation of protection-related
concerns (COE I.37 & 39). If an individual
gives you a disclosure suggestive of abuse,
record it in detail, even if it is tangential to
your treatment purpose.
The COE (IV.25) requires that we ensure
our information does not mislead, and is not
misunderstood by, mandated agencies. We
have a responsibility to promote the fair
treatment of our client, and to ensure that
confidentiality rights are maintained in other
areas (Encourage Dignity of Persons). Thus,
where the information provided would in
your judgment require professional training
in order to provide appropriate
understanding, inform the Agency of that
opinion and offer such understanding in the
interest of protecting your client.
The Role of Psychologists in Child
Protection Investigations
There is a role for a Psychologist in a child
protection investigation. The Guidelines
note that the agency may need to collaborate
with ‘others’ (e.g., psychologists) in
gathering evidence to establish “a serious
and persistent pattern of abuse likely to
cause emotional disability of a significant
nature” (Part (3) 4). Such a professional
opinion is necessary for the agency to
defend acting to protect a child from
emotional abuse. If you have professional
training to make such an assessment, this
may be a role you could undertake, as part
of the investigation.
For several ethical reasons, be very cautious
about making opinions regarding emotional
abuse if you are involved in another
relationship (e.g., therapist) with the child
who is the subject of investigation, or with
the individual who is the target of suspicion.
Avoid dual relationships. It is likely
ethically wiser to defer responding to a
request for such an opinion because you
cannot have both the child and the mandated
agency as your client. That does not mean
you should remain silent. You may be in a
sound position to give an opinion regarding
that child’s emotional health and the current
level of parenting care required by this child.
If you are treating an adult for mental health
issues and that adult is a parent, then
questions regarding the impact of the
treatment issue on parenting are germane. I
maintain that you have an obligation to
survey this area and respond accordingly
(COE I.47 Respect for Dignity of Persons,
Extended Responsibility). If mental health
issues are impacting on parenting,
contacting CFS may generate a collaborative
supporting response (e.g., using support
homemakers, engaging alternate significant
adults to help) that pre-empts the need to act
in a mandated fashion.
Conclusions of the Investigation
Something new, and welcome, is the closure
of the feedback loop regarding the reporting
of protection concerns to the agency.
According to the Guidelines, once an
investigation has been concluded, you as the
person who initiated the investigation
through your report should receive
notification of the agency’s conclusion (Part
4 and Act section 18.4) that the child was or
was not in need of protection.
Province of Manitoba (March 1999) The
Child and Family Services Act of Manitoba.
Winnipeg: Author.
Thank you for this opportunity to review
some issues for psychologists regarding our
response to issues of child protection. I see
us as active partners with other professionals
in attending to the protection issues that are
either manifest or latent in almost every
child and adult mental health client
situation. In preparing this document, I
surveyed some Winnipeg Child and Family
Services protection workers regarding their
working relationship with psychologists in
general. While they had general concerns
about the cooperation they garnered from
other professionals, they reported
psychologists to be generally responsive to
their enquiries. It is gratifying to have such
respect reflected in their comments. The
working relationship between mandated
workers and other professionals has such
potential for distortion that it begs
discussion in another forum.
As members will recall, the Examination for
Professional Practice in Psychology has
moved from its traditional twice a year
paper and pencil administration schedule to
an on-demand computer-administered
version available locally through Sylvan
Learning Centres. It is more expensive for
the Professional Examination Service to
develop, maintain, and administer the test in
this fashion, and as a courtesy to examinees
PES has been phasing-in these increased
costs over a two-year period.
For additional information about topics
raised in this article, contact Dr. Greenwood
at 787-4563 or via e-mail:
LGreenwood@exchange.hsc.mb.ca
References
Canadian Psychological Association (2000)
Canadian Code of Ethics for Psychologists –
Third edition. Ottawa: Author.
Canadian Psychological Association (1989)
Practice Guidelines for Providers of
Psychological Services. Ottawa: Author.
Province of Manitoba (2001) Revised
Manitoba Guidelines on Identifying and
Reporting a Child in Need of Protection
(Including Child Abuse) Winnipeg: Author.
EPPP FEES TO INCREASE
SUBSTANTIALLY IN DECEMBER
Locally, we have been benefiting
additionally because our members have been
charged in Canadian dollars at par with U.S.
dollars for the EPPP. As of December,
2002, however, PAM has been informed that
our costs will no longer be covered at par.
This means that the cost of the exam will
increase substantially to $450 U.S. (exam
fee), along with a $65 U.S. administration
fee to Prometric, which is contracted to
deliver the tests through Sylvan Learning
Centres.
If you have any questions about the EPPP or
these fees, please contact the Registrar at
487-0784.
Please note that PAM does not make any
money on the administration of the exams.
We are charged the fees as noted above,
which we are then responsible for collecting
from members or candidates who take the
exam.